Нейромониторинг рассматривается в широком понятии, включая динамическую оценку неврологического статуса, дискретное или непрерывное использование электрофизиологических, биохимических, ультразвуковых, рентгеновских, изотопных и других методов. Несмотря на современные технологические возможности, динамическая неврологическая оценка продолжает оставаться одним из наиболее простых и важных способов оценки адекватности интенсивной терапии. Более того, данные инструментальных методов всегда должны рассматриваться только в сопоставлении с клинической картиной. Нарастание степени угнетения сознания, глубины двигательных и тонических расстройств, увеличение числа симптомов «выпадения» ЧМН отражает неэффективность терапии.
Neuromonitoring is broadly considered including dynamic neurological examination, discrete and continuous application of electrophysiological, biochemical, ultrasonic, X-ray, isotope and other methods. The dynamic neurological examination continues to remain as one of the easiest and the most important ways of adequate assessment of intensive treatment despite modern technological capabilities. Moreover, the instrumental procedure data shall be always considered just within the comparison with clinical practice. The increase of the depression of consciousness degree, the depth of movement and tonic disorders, multiplication of the incidence of SBN (Skull Brain Nerves) "loss" symptoms reflect the ineffectiveness of treatment. Cerebral - corporal para infrared oxymetrical system is suitable for estimating the patient’s (infantschildren-adults) condition with possible disorder of cerebral and/or corporal oxygenation even with keeping normal degrees of Arterial blood pressure and SpO2. rSO2 index is indicative of the balance between oxygen delivery and intake within the regions of interest. This method is used as intraoperative neuromonitoring in cases of high risk of hypoxic brain damage during surgical interventions on the vessels of the neck, surgical treatment of chronic pulmonary embolism, aneurysm and aortic dissection, as well as to assess the severity of cerebral ischemia in patients with chronic cerebral ischemia, pathology of the arteries of the head and neck, chronic pulmonary embolism. The method is based on the principle of optical spectroscopy using infrared light with a range from 650 to 1100 nm. The sensor of the device is located in the frontotemporal part at the border of the scalp. The saturation of the brain with oxygen is determined at rest in the supine position while breathing atmospheric air at all stages of surgical treatment in a continuous monitoring mode.
Acute-on-chronic pulmonary embolism and concomitant paradoxical embolism: two diseases, one intervention
